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HomeMy WebLinkAbout040-1175-10-000 o V 3 0 o 0 vq~ M N y O o ad N a y N 7 a > O U C p~p O (0 U ~ Y = V1 C O T C > U U v c Z aai OH 7 f6 N y OD LL O C .C- r N N " N E Q w =o E I cUi I ~ N Z w C z 9 00 NCO ! am C O O Z L) CO I- r N Z (h N N ` co N C M C C C N L ° 0 0) 0 m w O Z N E N tv V ° n. c U G G IL N fq C~V fA fA fA v v o o 5 5 5 d U a CL IL a. V)l a 13 c a=o(j) I U) J V y Q p 01 01 cc Lo 0 (D D 0 Q <A co N A N o O C N N C O 0 O ! N y U d o-. o T C U. d C N N W N H C N 0 L n C co m .yd. d C F_I O N ` N M O U) E U • O O N F- r O z C Co CC I Cd v~ d R € a L: IL rww y E CL .2 t A UoCm 2- ~i0 Form -STC - 104 AS BUILT SANITARY SYSTEM REPORT t0WNER"•f1zct, tYl€sl ~ TOWNSHIP SEC. 2-4 T 2L N-R 2-C, W r . ADDRESS ~?_10 • ci~~ Ch ST. CROIX COUNTY, WISCONSIN • ~-~U.r~~cr~t, ~.°u~ - Syt'-ifs SUBDIVISION LOT 1?_C -,ZI LOT SIZE +X' x 3't•S PLAN VIEW Distances and dimensions to meet requirements of I1UR 83' SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM r-1 lob J 'IN INDICATE NORTH ARROW BENCHMARK: Describe the vertical reference point used , 0,0Cw,2r Elevation of vertical reference point: iCC, k~u Proposed slope at site: > u~`lo SEPTIC TANK: Manufacturer: =z-sfAt_ _ Liquid Capacity: I z-Sy C ,~`5 '-'--`•Numbe= of rings used: Tank manhole cover elevation: zz- • Tank Inlet Elevation: f& 61 Tank Outlet Elevations Number of feet from nearest Road: Front O Side Rear, ~z~O Vf--!00,2 , feet From nearest-property line : Front ~Side ,ORear,O 0.75--1 feet Number of feet from'. well (cc, building: I~ Vii' (Include this information of-the above plot plan)( 2 reference dimensions to septic tank) SEE, REVERSE SIDE 4 u PUMP CHAMBER 5t- - . . Li ' Manufacturer: Liquid Capacity: Pump Model: 51_•41•- Pump/Siphon Manufacturers . f7 t•I„~_ Pulp size 51L Elevation of inlet: ~11c .49 Bottom of tank elevations C43 - 19 Pump off switch elevation: Gallons per cycles „ 1CI Alarm Manufacturer: S, S EWcTxc_9#i. Alarm Switch Type: -Number of feet from -nearest property lino:'. Front, OSide, ORear,~ Ft. 'Number of feet from well: (oF'-- Number of feet from building: (Include distances.on plot plan). SOIL ABSORPTION,SYSTEM Bdd r X' Trench t Width: iV1 Lengths '76~ ' .,'Number of Linea: 3 Area Built: '1= Fill depth to top of pipes 2-14, Number of feet f 'am nearest property line: Front, OSide, Rear,0It ~L i Number of feet from well: N 'bar of feet from building: _C (Include di Lances on plot plan). SEEPAGE PIT Size: Number of pits: Diameters Liquid depth: Bottom of seepage pit elevation: Area Built: t Has either a drop box O or distribution box0 been used o:k any of the above *oil absorbtion sytems4 (C eck one). HOLDING TANK Manufacturer: Capacity: Number of'.rings used:. Elevation of bottom of tank: Elevation of inlet: Number of feet from nearest property line: Front, O Side, O Rear, OFt. Number of feet from well: Number of feet from building: Number of feet from nearest roads Alarm Manufacturer: Inspector:. Dated: ~o D Plumber .on job: License Number: / VPr'_' s W 8 73 9 3/84:roj j DEPAPNJENT~Oif-A6USTRY, INSPECTION REPORT FOR SAFETY & BUILDING DIVISION LABOR & HUMAN RELATIONS P.OQBOX 79vy69 ON-SITE SEWAGE SYSTEMS OFFICE OF DIVISION CODES & APPLICATION S E 450] 4, S 2 C, 2 ~F , T28- R2 0 State Plan I.D. Number: N 53707 (It assigned) CONVENTIONAL ❑ ALTERATIVE Town of Trov ❑ nd S o I Tank ❑ In-Ground Pressure Mou A E: NAME OF PERMIT HOLDER: - Lots ADDRESS OF PERMIT HOLDER: INSPECTI NO 2 o R Hudson, WI 54016 5 5 Fr 1 REF. PT. EL V.: ST RE . PT. E BENCHMARK (permanent reference point) DESCRIBE IF DIFFERENT FROM PLAN: - Name of Plumber: MP/MPRSW No.: County: Sarittaiy rmlttdumbec Paul R. Cudd 2719 S roix 135482 SEPTIC TANK ra MANUFACTURER: LIQD CAPACITY: T K EV.: TA O 1=T ELEV.: WARNING LABEL LOCKING COVER UI PROVIDED: PROVIDED: NO YES ❑ NO ❑ YES BEDDING: VENT DIA.: VENT MATE.: HIGH WATE NUMBER OF ROAD: PROPERTY WELL: BUILDING: VENT TO FRESH AIR INLET: LINE: ALARM: FEET FROM ❑ YES ❑ NO . ❑ YES ❑ NO NEAREST DOSING CHAMBER: %4,11~' ~dGZarri = .3 8 MANUFACTURER: BEDDI G: LIQUID CAPACITY: PUM MODEL: PUMP/SIP[•i6N MANUFACTURER: WARNING LABEL pLOCKING ROVIDED:OVER PR VIDED: ❑ YES NO 3S? CCx'C& YES ❑ NO ES ❑ NO PUMP AND CONTROLS OPERATIONAL: NUMBER OF PROPER WELL: BUILDI VENT TO FRESH GALLONS PER CYCLE: FEET FROM LINE: AIR WEFT: (DIFFERENCE BETWEEN ❑ YES ❑ NO NEAREST PUMP ON AND OFF LENGTH: 3 DIAMETER: MATE I L~AND MAI fCINQ SOIL ABSORPTION SYSTEM. Check the soil moisture at the depth of plowing FORCE ar r) ~C* or excavation. (If soil can be rolled into a wir , construction shall cease until MAIN the soil is dry enough to continue.) CONVENTIONAL SYSTEM: WIDTH: LENGTH: NO. OF DISTR. PIPE SPACING: COVER INSIDE DIA.: # PITS: LIQUID BED/TRENCH t TRENCHES: _UAIERIAL: PIT DEPTH: DIMENSIONS le GRAVEL DEPTH FILL DEPT DISTR. PIPE DISTR. PIPE DI TR. PIPE MATERIAL,. N .DISTR. NUMBER OF PROPERTY WELL: BUILDING: VENT TO FRESH BELOW PIPES: ABO~ E CO : ELEV. INLET: ELEV. END: ~ " - y 7 /l - PIPES: LINE: , AIR INLET: C/I7 ~7/ ~y '~G FEET FROM ~ ~ G 910, a3 -7"t' f_ L.1 ' rn ~ NEAREST ~ MOUND SYSTEM` > r Mound site plo' d -erpendicular to Check the texture of the fill material for PROVIDE A DIAGRAM OF SYSTEM slope and furrows thrown unslope: mound systems to make certain that it ON REVERSE SIDE. SHOW EYES ❑ NO meets the criteria for medium sand. ELEVATIONS MEASURED. SOIL COVER TEXTURE: PERMANENT MARKERS: OBSERVATION WELLS; ❑ YES ❑ NO ❑ YES ❑ NO DEPTH OVER TRENCH/BED DEPTH OVER TRENCH/BED DEPTHS OF TOPSOIL: SODDED: SEEDED: MULCHED: CENTER: EDGES: ❑ YES ❑ NO ❑ YES ❑ NO ❑ YES ❑ NO PRESSURIZED DISTRIBUTION SYSTEM: WIDTH: LENGTH: TRENCHES: LATERAL SPACING: GRAVEL DEPTH BELOW PIPE: FILL DEPTH ABOVE COVER: BED/TRENCH DIMENSIONS MANIFOLD PUMP MANIFOLD DISTR. PIPE MANIFOLD MATERIAL: P o.. DISTR. DISTR. PIPE DISTRIBUTION ELEVATION AND PIPE MATERIAL & MARKING: ELEV.: ELEV.: DIA.: ELEV.: DISTRIBUTION HOLE SIZE: HOLE SPACING: DRILLED CORRECTLY: COVER MATERIAL: VERTICAL LIFT CORRESPONDS TO INFORMATION APPROVED PLANS ❑ YES ❑ NO ❑ YES ❑ NO PERMANENT MARKERS: OBSERVATION WELLS NUMBER OF PROPERTY WELL: BUILDING: COMMENTS: FEET FROM LINE: E] YES E:1 NO ❑ YES ❑ NO NEAREST' LlUF:~ D Ret in in county file for audit. Sketch System on TITLE: Reverse Side. SIGNAT E: i~ SBD-6710 (R. 06/88) SANITARY PERMIT APPLICATION " ~0ILHR In accord with ILHR 83.05, Wis. Adm. Code COUN r STATE SANITARY PERMIT # -Attach complete plans (to the county copy only) for the system, on paper not less than 1:1 8% X 11 inches in size. Check if revision to prev us application -See reverse side for instructions for completing this application. STATE PLAN I.D. NUMBER 1. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION. PROPERTY OWNER PROPERTY LOCATION Fred Mangine SE % NW %,S 24 T 28 , N, 1420 10W PROPERTY OWNER'S MAILING ADDRESS LOT # BLOCK # 270 Cove Rd. 20 & 21 CITY, STATE ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER Hudson, WI 154016 1(715 386-345 St. Croix Cove II. TYPE OF BUILDING: Check one CITY NEAREST ROAD ( ) 11 State Owned vILLAGE : Tro South Cove Rd. 1:1 Public ®1 or 2 Fam. Dwelling-# of bedrooms AR AX NU R( S) 111. BUILDING USE: (If building type is public, check all that apply) 040-1175-10 1 ❑ Apt/Condo 2 ❑ Assembly Hall 6 ❑ Medical Facility/Nursing Home 10 ❑ Outdoor Recreational Facility 30 Campground 70 Merchandise: Sales/Repairs 11 ❑ Restaurant/Bar/Dining 40 Church/School 80 Mobile Home Park 12 ❑ Service station/Car Wash 5 ❑ Hotel/Motel 9 ❑ Office/Factory 130 Other: Specify IV. TYPE OF PERMIT: (Check only one in line A. Check line B if applicable) A) 1.0 New 2. ® Replacement 3. ❑ Replacement of 4.0 Reconnection of 5.0 Repair of an System System Tank Only Existing System Existing System B) ❑ A Sanitary Permit was previously issued. Permit # - Date Issued V. TYPE OF SYSTEM: (Check only one) Non-Pressurized Distribution Pressurized Distribution Experimental Other 11 ❑x Seepage Bed 21 ❑ Mound 30 ❑ Specify Type 41 ❑ Holding Tank 12 ❑ Seepage Trench 22 ❑ In-Ground 42 ❑ Pit Privy 13 ❑ Seepage Pit Pressure 43 ❑ Vault Privy 14 ❑ System-In-Fill VI. ABSORPTION SYSTEM INFORMATION: 1. GALLONS PER DAY 2. ABSORP. AREA 3. ABSORP. AREA 4. LOADING RATE 5. PERC. RATE 6. SYSTEM ELEV. 7. FINAL GRADE REQUIRED (sq. ft.) PROPOSED (sq. ft.) (Gals/day/sq. ft.) (Min./inch) ELEVATION 600,00 1260 1260 Class 2 95.5 Feet Feet VII. TANK CAPACITY Site in allons Total # of Prefab. Fiber- Exper. INFORMATION New lExisting Gallons Tanks Manufacturer's Name oncrete Con- Steel glass Plastic App Tanks Tanks structed Septic Tank or Holdin Tank 1 Lift Pump Tank/Si hon Chamber 1 10 0 1 Wieser VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name (Print): P is Signat re: o Stamps P/MPRSW No.: Business Phone Number: Paul R. Cudd MPRSW 2739 715 425-2049 ;~~z ~1_ Plumber's Address (Street, City, State, Zip Co dg): Rt. 5, Box 364, River Falls, WI 54022 IX. C UNTY/DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued Issuing A em Signature (No Stamps Approved ❑ Owner Given initial / Z Surcharge Fee) Adverse Determination X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL: SBD-6398 (formerly Plb-67) (R. 11/88) DISTRIBUTION: Original to County, One Copy To: Safety & Buildings Division, Owner, Plumber A INSTRUCTIONS 1. A sanitary permit is valid for two (2) years. 2. Your sanitary permit may be renewed before the expiration date, and at the time of renewal any new criteria in the Wisconsin Administrative Code will be applicable. 3. All revisions to this permit must be approved by the permit issuing authority. 4. Changes in ownership or plumber requires a Sanitary Permit Transfer/Renewal Form (SBD 6399) to be submitted to the county prior to installation. 5. Onsite sewage systems must be properly maintained. The septic tank(s) must be pumped by a licensed pumper whenever necessary, usually every 2 to 3 years. 6. If you have questions concerning your onsite sewage system, contact your local code administrator or the State of Wisconsin, Safety & Buildings Division, 648-266-3815. To be complete and accurate this sanitary permit application must include: 1. Property owner's name and mailing address. Provide the legal description and parcel tax number(s) of where the system is to be installed. II. Type of building being served. Check only one and complete # of bedrooms if 1 or 2 Family Dwelling. Ill. Building use. If building type is Public, check all appropriate boxes that apply. IV. Type of permit. Check only one in line A. Complete line B if permit is for tank replacement, reconnection, or repair. V. Type of system. Check appropriate box depending on system type. VI. Absorption system information. Provide all information requested in #1-7. VII. Tank information. Fill in the capacity of every new and/or existing tank, list the total gallons, number of tanks and manufacturer's name. Indicate prefab or site constructed and tank material. Complete for all septic, pump/siphon and holding tanks for this system. Check experimental approval only if tanks received experimental product approval from DILHR. VIII. Responsibility statement. Installing plumber is to fill in name, license number with appropriate prefix (e.g. MP, etc.), address and phone number. Plumber must sign application form. IX. County/Department Use Only. X. County/Department Use Only. Complete plans and specifications not smaller than 8% x 11 inches must be submitted to the county. The plans must include the following: A) plot plan, drawn to scale or with complete dimensions, location of holding tank(s), septic tank(s) or other treatment tanks; building sewers; wells; water mains/water service; streams and lakes; pump or siphon tanks; distribution boxes; soil absorption systems; replacement system areas; and the location of the building served; B) horizontal and vertica! elevation reference points; C) complete specifications for pumps and controls; dose volume; elevation differences; friction loss; pump performance curve; pump model and pump manufacturer; D) cross section of the soil absorption system if required by the county; E) soil test data on a 115 form; and F) all sizing information. - - - - - - GROUNDWATER SURCHARGE 1983 Wisconsin Act 410 included the creation of surcharges (fees) for a number of regulated practices which can effect groundwater. The monies collected through these surcharge:r are used for monitoring groundwater, ground- water contamination investigations and establishment of standards. SBD-6398 (R.11/88) r r . APPLICATION FOR SANITARY PERMIT STC - 100 i This application form is to be completed in full and signed by the owner(s) of the property being developed. Any inadequacies will only result in delays of the permit i issuance. Should this development be intended for resale by owner/contractor, ("spec house"), then a second form should be retained and completed when the property is sold and submitted to this office with the appropriate deed recording. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Owner of Property Location of Property 3%, Section T ? N-R G~ W v./ Township Mailing Address Address of Site Subdivision Name Lot Number Previous Owner of Property Total Size of Parcel Date Parcel was Created < ~1 Are all corners and lot lines identifiable? Yes No Is this pro erty being developed for resale (spec house) ? Yes No Volute - and Page Number 37;;~; as recorded with the Register of Deeds. x_377 r~~VCLUDE WITH THIS APPLICATION THE FOLLOWING: A Warranty Deed which includes a Document number, volume and page number, and the Seal of the Register of Deeds. In addition, a certified survey, if available, would be helpful so as to avoid delays of the reviewing process. If the deed description refer- ences to a Certified Survey Map, the Certified Survey Map shall also be required. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - PROPERTY OWNER CERTIFICATION I (We) ceAti.by that a t statements on this 6onm ahe true to the best o6 my (oun) knowledge; that I (we) am (ate) the owner (s) o6 the pnopWy des oti.bed in this -i,n6onmation 6onm, by v.ihtue o6 a wa~vcant deed %econded in the 06 ice o the County Regeaten o6 Veedbab Document Na ;and that I (We) pnesentty own the proposed site bon the sewage d%spas sys em (on I (we) have obtained an easement, to nun w.cth the above deami.bed pnopenty, bon the eowatnuction a6 .aai.d system, and the tame has been duty recorded in the 066ice o6 the County Regi.6ten o5 Veede, ab V oeument No. ) . -7 SIGNATURE OP.OWNER SIGNATURE OF 0-OWNER (IF APPLICAB DAT~GNED DATE SIGN Ho. epf. Warranty Deed-Statutory Form-Win. State: 286.06. Published by Kau Clain Book a staftsa 800f t Fr38 2E;G~7G WARRANTY DEED Winford, Inc. a corporation duly organized and existing under the laws of Wisconsin, having its principal office in the City of Hudson, St. Croix County, Wisconsin, grantor, hereby ConbQ0 AnbIMattanO to Fred F. Mangine and Mary T. Mangine, husband and wife, as. .,joint tenants and not as tenants in common. • Minnesota of Ramsey County, Wiscl xmilo, grantee for the sum of One ($1.00) Dollar and other valuable consideration Boners the following tract of land in _ St. Croix _ County, in. the-State. of Wisconsin. Lot twenty (20), St. Croix Cove Subdivision, according to the plat thereof on file and of record in the office of the Register of Deeds in and for said County. Subject to restrictions and protective covenants of record and further subject to the Declaration of Winford, Inc., to the Public, dated April 24, 1957, acknowledged May 31, 1957, and recorded June 7, 1957 in Book 339 at page 325, in the office of the Register of Deeds in and for St. Croix County, Wisconsin, and the conditions contained therein. This deed given inlieu of earlier deed which improperly described property herein conveyed. 30 401ttntOO i1 punt, the said grantor has caused this deed to be signed by its president;-couptersigneal .ayof° Sri . its secretary, and*its corporate seal hereunto abized this 7th d eptember ,19 61 - j a . In es ce of ~...G:. WIN FORD IN C _ - ra_ H Clapp President. 1 Nan M-- -Tarobson William D Clapp Countersigned - ` Assistant Se etary. Edward D Clapp J Corporate 1 Seal MINNESOTA Statt of AMWOKSlElYi Ramsey County.} ss. - Personally came before me this 7th day of September 1961 the above named William D. Clapp President and Edward D. Clapp, Assistant Secretary of the Winford, Inc. to me known to be the persons who executed the foregoing instrument and ac owledged that they executed and deli eyed th same as ^r r. . and for the act and deed of said corporation. NMI REGISTERS OFFICE ST. CROIX CO.. WIS. W. H. CLAP . Notary Public, Ramsey County, inn: Recd for Record this-3,3#,h_ My, Commission Expires July 29, 1968 day of---- AQt,_A.D.1961 f at------ UILQQ-Ae, M. ]2 1 Ho My Commission expires ' ; 19 1{to~isielof Oes40 f (To be Allied in if shined by a Notary Pubj% ~/•~-c (MBA.-•bi. 60 Is. eta``t*-b~fdea at all Instruments to be recorded shall have plainly p=lated or typewritten thereon the names of the ra, Xraatees, wit> ea and notary.) Form No. 105 . r r Y SEPTIC TANK MAINTENANCE AGREEMENT - 0 St. Croix County z y OWNER/BUYER GG~L~' ra ROUTE/BOX NUMBER Fire Number;~;- CITY/STATE ZIP PROPERTY LOCATION: ~4, Section T,28 N, RAW, Town of fZ~- St. Croix County, SubdivisionV LL~- Lot number I Improper use Jnd maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance con- sists of pumping out the septic tank every three years or sooner, if needed, by a licensed septic tank Lumber. What you put into the system can affect the function of the septic tank as a treat- ment stage in the waste disposal system. St. Croix County residents may be eligible to receive a grant for a max_imu_m_ of 607 of the cost of replacement of a failing system, which was in operation prior to July 1, 1978. St. Croix County accepted this program in August of 1980, with the requirement that owners of all n_e_w systems_ agree to keep their systems properly maintained. The property owner agrees to submit to St. Croix County Zoning a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper veri- fying that (1) the on-site wastewater disposal system is in proper operating condition and (2) after inspection and pumping (if nec- essary), the septic tank is less than 1/3 full of sludge and scum. Certification form will be sent approximately 30 days prior to three year expiration. 0 I/WE, the undersigned, have read the above requirements and agree to maintain. the private sewage disposal system in accordance with x H the standards set forth, herein, as set by the Wisconsin Depart- It ment of Natural Resources. Certification form must be completed ~ and returned to the St. Croix County Zoning Office within 30 days of the three year expiration date. SIGNED / Cam/ / t DATE St. Croix County Zoning Office Sign, date and return to above address. DEPARtMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS INDUSTRY, DIVISION 7969 LABOR AND PERCOLATION TESTS (115) MADISONP.O., WI BOX 53707 3707 HUMAN RELATIONS (ILHR 83.09(1) & Chapter 145) LOCATION: SECTION: TOWNSHIP UNICIPALITY: LOT NO.: BLK. NO. SUBDIVISION NAME: cc,us_ sE~/SVw~/ z zsN/Rzo Ecor o1_( zoeZI - I sr•t%4 )'L COUNTY: UYER'S NAME: MA LING ADDRESS: 27() C'_ZVE (ZAt 'ST' c-ZJ1K. 1-"x•20 'M ANGIti1L OSOAJ ItiJ 1 5YO/6 USE DATES OBSERVATIONS MADE NO. BEDR 0 R AL D S R PT10N: I N STS: Residence L/ N- A . ❑ New ~LReplace S_ _ 90 JV . A. RATING: S= Site suitable for system U= Site unsuitable for system -FILL HOLDING TANK: RECOMMENDED SYSTEM: (optional) a~ IN G lI P SYSTEM-IN CONVENTIO❑NU . IMOUND- SS RE: ,(,J S ❑U QS 01 Co><1V8j`DLwPr - If Percolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in the e under s. ILHR 83.09(5)(b), indicate: CLI'vgs Floodplain, indicate Floodplain elevation: PROFILE DESCRIPTIONS BORING TOTAL DEPTH T R UNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH IN. ELEVATION OBS RVED EST.HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) B a8 too.o tvo►~vL. > 98 SEFE pf8EE z OF 2 B- 3 88 °t~.~ > SS ~r B- B- B- PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP I WATER LEVEL-INCHES RATE MINUTES NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD 1 PERIOD PER INCH P- P- P- P- P- P- PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori- zontal and vertical elevation reference points and show their location on the plot plan. Show the surface elevation at all borings and the direction and percent of land slope. B3MAI OF t~CD P A~ G~ $ I u~risv r-tL~p SYSTEM ELEVATION a s- s " I s . TWO- . c E~5 CUM . I I. ~.1 IT A 07 1L-L ►DO. ~ cTJ 9~ S 1 I 1 r,N A9.3 Lo o S w~n ok" 41 i ; I I i ' I, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and methods specified in the Wisconsin Administrative Code, and that the data recorded and the location of the tests are correct to the best of my knowledge and belief. NAME (print : AND TESTS WERE COMPLETED O : _S_)_90 ADDRESS: DESIGN ISERVIOE CERTIFICATION NUMBER: PHONE NUMBER (optional): cSTOOO sI 6 ~)S-(1zS-o/65 12 Or ROX74 421 N. MAIN • CST SIGNAT RE: RIVER FALLS; WI 54022 715-425-0165 DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. ~kC1~ of DILHR-SBD-6395 (R. 10/83) - OVER - SOIL DESCRIPTION FORM t2 Soil protile Location-Map On a Su orate Shsetl C4 JV (N AR 0 T , S StOPE:l V ~~~~T SYS V t DESCR1PtlON BY l~~V~~' w LPfrT l `C~4 CURRENT LANO USE: L Fl'Cw1 J OATir VEGE ATIVE COVER- G S S COUNTY/STATE: sT. -pm tX C.4Q CoVF 1_- Z0 4 Z-( 3T- cI DRAINAGE CLASS: l v LLL- ~ ~JVKj LOT OESCRIPTION:OCATION: TOW tJ O F l1 GALLONS- PER SO. FT. PER DAY t 0 - t4 8 SOIL SERIESt K., E1~~"~~ S PARENT MATERIAL EPTIJ; TEXTURE STRUCTURE CONSISTENCE CLAYSKINS/ PORES FKNt120N DEPTH MATRIX COLORS MOTTLES ROOTS PH -BOUNDARY REMARKS n• moist G Sz. Sh COATINGS 8o u 6 v , o~. 8Tn L ) Wt In v'~'r a. S 1 0- ~o~R z~ z Ott. Y• 8r\ Q- S L~ - \S 1 OY [Z 3 / - S 1 h7 $ 1~1 ~1 V `~t~+ It* -'r- s 1 9bb: rl S 3 1S _ y )o-fR 3/ Dti- `3Y\ Q $ M 5 °~u 6fLRv~'l YO-98 -).SYIt 91- m S 1Zl x3a Z V- Ott- I3 h yr. M V 0. S I o-L! IQ-rp- "Wm. Y. eh 5 % GRR uek ~oktz -1 /y - hl - S o S r'►~ ott. eh L twL w► v `t s IL. ok. K D C S Z S. qo - Yha~I~1-S p mV`F bh `i @h yM ckY S d s u'n S % GRvWt~1 i OTHER SITE FEATURES/NOTES: _ 000 S7 b /~y(if nn GL? z of Z Signature Date CST 8 LIMITING FACTORS/DEPTH: Y-I RIV GI IV Owner's name San. Permit No. p OF Ll H63.05 PLOT PLAN Show: F71 Location of building served v' Dosing chamber Q Septic tank Vertical/horizontal reference ppint 8~► GZL'lov.C*.) Gv c-f.)'Tu+EV- of ccwctwe R-S 3"t'*j Building sewer Q System elevation is q S,5' F` Effluent system © Well Replacement system area F~;T Property lines w/in 50' of system Distribution boxes Scale 0 , or dimensioned ~ noDosL E Pump and controls: Goc~~OS pWYr~S,1~uc, 3 8g Mfr. & Model No. Vertical Lift Size Force Main Friction Loss T. D. H. Vol. Dist. Pipe Gal. per Min. Gal. per Cycle Place check mark in appropriate box, indicating item is shown on plot plan below: ilOD~ LoT LI/VC L=-X(ST))UG S es lln c tic *vt 4 bR Lj4vt'1..L Tu @e pjsm owe1 ~R ft-h ~ D A%T Pep- =IL- ~Dl~ s V~rBZ ~o a y s ry1W. Gl pJpMj q r,6 X 1L d a, Q 720 ~o L di 0 u QJ Cam, r ,as 4yPV ►lyr/FT Stake O~ A oQT` ./n'~ l/-~STfCI.~ 1250 G l.I.ON ~ . ~ W lF9~iZ OdV G S C ZTWk Jd ~/u4T~c~-L lppp G~~t.o~u / w lE3@tF Puw~ Cti#! DER t_ uT f-/ ll .4s By the granting or approving of the above plan, or upon the event of a subsequent permit.being issued, St. CroixCounty and theSt.CroiXCounty Zoning Administrator, does not assume or hold itself liable for any defects in plans or specifications, plan omission, examination oversight, construction, or any damage that may result in or of installation. ~ .37 _ MPRSW 2739 P um r s signature lcense o. a e f , • ~ OSS SECTION OF A QED SYSTEM PAGE 2 OF 4" Cast Iron Vent Pipe 12" Above Finished Grade 4" PVC Distribution Pipe Z Soft Fi11 2" Of Aggregate Q Approved Synthetic c-`~,_ 46 Dr Cover Material or bS~ ` `~;\~9++ of Uncompacted 6 - Of -'"-22" Ag gate F St aw Or Marsh Hay. Elev cl S t S Feet a- Perforated Pipe To Bottom Of Bed. bISTRIBUTION PIPE TO BE AT LEAST ~INCHES BELOW ORIGINAL GRADE AND AT LEAST 20-INCHES BUT NO MORE THAN 42 INCHES BELOW FINAL GRADE. MA1'_1XUUIVL-_DEPT1R,OF EXCAVATION FROM ORIGINAL GRADE WILL BE 58 INCIIES. MINI!-NM DEPTH OF EXCAVATION FROM ORIGINAL GRADE VULL BE INCHES. PLAN VIEW OF BED r 1' f 4" Perforated PVC Di stribut1 o Pipe. z'' pvq. Rc~ ,~,r,N - F~,r~ C~~MP cHA~nsER Cast -Iron Vent Pipe Solid Wall PVC Header Pipe ASE 3 o PUMP CHAMBER CROSS SECTION AND SPECIFICATIONS VENT CAP 4" C.I. VENT PIPC WEATHER PROOF APPROVED LOCKING JUNCTIOW BOX MANHOLE COVER WITH 25' FROM DOOR, wRRNIN 6 L,I~BEL WuJDOW OR FRESH IL~MILI. I AIR INTAKE I &KADE' I H' MIN. l p° -O I WAIN. COWDUIT-/ IV 1h _ PROVIDE I . INLET AIRTIGHT SEAL -T I III ~ I III v APPROVED JOINT A I III APPROVED JOINTS W/C.T. PIPE I III ALARM W/C.I. PIPES PVC EXTENDIAIb 3' OWTO $0610 $01 L e . I I I ' I t ,r" I I ON c I I a1Z. L'2.. LLCV. , F T. PUMP--,-- OFF O CONCRETE 5LOCK APPRa/ED ggODl~ RISER EXIT PERMITTED OIJLy IF TANK MAIJUFACTURCR HAS SUCH APPROVAL SPEC,IFICATIOUS DOSE TANK MANUFACTURCR. L~I~~ CONE NUMBER OF DOSES: 3 3 PER DAU TANK 51ZE'.»CO GALLOWS DOSE VOLUME ALARM MANUFACTURER' S.S. LLe`C~ 1 SL' 3721 S INCLUDING BAC.KFLOW: ZOI GALLONS MODEL WUMBCR: 1p) hIw CAPACITIES: A=_L.INCHES OR yol.9 GALLONS SWITCH TyPC: I- lta'Nz calla B = Z INCHES OR G~ LLOUS ~y"►pS, l/vC,• Cs INCHES OR ~OI'O GALLOWS PUMP MANUFACTURER: ~ou~-OS j 111+ MODEL NUMBER. 3811 4 D- 1327- INCHES OR 38~'ID GALLOWS SWITCH TYPE' >11 e~tc-Q1iY DOTE: PUMP AMD ALARM ARE TO BE MIWIMUM DISCHARGE RATE y 1 GPM INSTALLED ON SEPARATE.CIRCUITS I VERTICAL DIFFERENCE BETWEEN PUMP OFF AUD_OISTRIBUTIOU PIPE.. FEET t MINIMUM NETWORK SUPPLY PRESSURE . . . . . z15 FLET ♦ ~Z S FEET OF FORCE MAIN X 3'S5 FYonFRICTIOU FACTOR.. Il-2 FEET TOTAL OtiWAMIG HEAD FEET 01 t11"1 EVER IAITERAIAL DIMEWSIOW~ OF TAWK: LENGTH 9970[' ;WIDTH I~ZnP ;LIQUID DEPTH '16 t3oTTvh ~42isA = z.3! _ ~ GRL. /1iuCN 7~S ~~1Z 1-~R1JU FACTVIZt~ _ ~8.7I ,sf - /1JCN f Submersible MODEL: 3871 SIZE: 3/4 SOLIDS Effluent Pump RPM: 1550 0.4 HP: METERS FEET 8 25 7 D 6 20 5- z 15 } 4 J 3 10 2 5 1 0 00 10 20 30 40 50 GPM 0 2 4 6 8 10 12 m3/h CAPACITY (Q GOULDS PUMPS, INC. S86CA A LS tew Nbw Gw8 P Effective October, 1988 01988 Goulds Pumps. Inc. SPECIRCATIONS ARE SUBJECT TO CHANGE WITHOUT NOTICE PRINTED IN U.S.A. Y-n K" cl 1v t= 13 VIVA ,Owner's name San. Permit No. / y n I OF H63.05 PLOT PLAN Show: Location of building served 1Z Dosing chamber o Septic tank Vertical/horizonthl reference point ~$1~1 10u. D o1v CA%A~ OF C.(yJCkzrTe R Building sewer System elevation is q S•S ' D Effluent system © Well Replacement system area Property lines w/in 50• of system Scale = 1 or dimensioned Distribution boxes ~EHu(~S co , ~ 3 8~ 3h Pump and controls: Mfr. & Model No. Vertical Lift Size Force Main .85 5.~3 1-LS.a 83 Zo Friction Loss T. D. H. Vol. Dist. Pipe Gal..per Min. Gal. per Cycle Place check mark in appropriate box, indicating item is shown on plot plan,below: l10-O' + LoT LINO r- l Lc~c. t S'1~1~+G S ~PTt` ~►tilrz ` d ~Zt ~l/nJLzL.L Tu Be oue%,4 C& t"f-3hkj /NS Few CoDL /i S.D,. 9 V~r aZ flSN ~ elm u Qv~ cam, a ~ es yy~ `off ~ ~ ~~~8~ y FT• StoR+~ ~ v c~veQ oueu PI L t►►SlPct L &7-50 G I tAAI WLF9~IL C,O~uG S ZTiNIc j~ ►w~S1rc~L 100 G+t~WN / LuT L~t,J P - By LE3 ~ ~cm Pury a C"M ea I By the granting or approving of the above plan, or upon the event of a subsequent permit being issued, St. CroixCounty and theSt.CroixCounty Zoning Administrator, does not assume or hold itself liable for any defects in plans or specifications, plan omission, examination oversight, construction, or any damage that may result in or after 'nstallation. 6-1-71 to 'Id 9 um r s signs ure icense o. Date CROSS SECTION OF A -':',ED SYSTEM PAGE Z OF 4" Cast Iron Vent Pipe 12" Above Finished Grade 4" PVC Distribution Pipe E-- Soil Fill 2" Of Aggregate S• Approved Synthetic Cover Material or of Uncompacted • 6 - Oftt-2" Ag gate w Or Marsh Hay Elev. ~15~5 Feet's .t - Perforated Pipe To Bottom Of Bed. bISTRIBUTION PIPE TO BE AT LEAST _INCHES BELOW ORIGINAL GRADE AND AT LEAST 20-INCHES BUT NO MORE THAN 42 INCHES BELOW FINAL GRADE. MA),_r.1 +~LUK--DEPTM,, OF EXCAVATION FROM ORIGINAL GRADE WILL BE SS INCHES. MINII•NM DEPTH OF EXCAVATION FROM ORIGINAL GRADE VrILL BE~INCFES. PLAN VIEW OF BED Perforated 14 PVC Distribut1 o 3~i p~q. Fotzc r~wrrn~ 6' i Pipe. - " FRar~ PowmP C Wsek 18- - - - - - - - ( C. 41' Cast -Iron Vent Pipe 3, - - Solid Wall PVC Header Pipe ' i`'>E 3 o F PUMP CHAMBER CROSS SECTIOIJ ARID SPECIFICATIOAIS VENT CAP H"C.I. VENT PIPC WEATHER PROOF APPROVED LOCKING f r-T JUUCTION BOX MANHOLE COVER wITH Z5' FROM DOOR, wAR1~1N 6 LAHEL WINDOW OR FRESH MIN. AIR INTAKE I GRAOC" I 14014 i ~L. 1 Oo _o I COAJDUIT WAIN. ~ h PROVIDE I INLET AIRTIGHT SEAL I III I 11 APPROVED JOINTS APPROVED JOIMT A ( III W/C.I. PIPE ORPVC W/C.I. PIPE ALARM EXTENDING 3' ONTO 601.10 WI L 8 I I I I ON c I I CLCV. FT. PUMP-~ OFF r 0 q ` p0 CONCRETE BLOCK 3" APPRwVED K15ER EXIT PERMITTED 0MLl IF TAWK MANUFACTURER HAS SUCH APPROVAL. gEDD~µG SPECIFICATIOAIS EK MAWUFACTURCR: w1ESeR C~ NUMBER OF DOSES:' 3 - 11 PER TA OAy TANK SIZE: ~O'00 GALLONS DOSE VOLUME AL_ ARM MANUFACTURMR: S.S. l:.I.E IRZ- S4s S INCLUDINCs OACKFLOW: 2'O I GAL1.oNS MOOCL NUMBER: 10) Hw CAPACITIES: AL_WCHESOR LIS11 9_GALLOUS SWITCH TyPE4 ~~12Q U1Zy B = Z INCNEt OR 5)' G~ LLONS F•- JCL -S s 7 IUCHES OR Z-0-2 GALLONS PUMP MANUFACTURCR: C. MODEL NUMBER: SR LI p s t3~t i INCHES OR 3 11° GALLONS SWITCH TYPE' NCU12.Y MOTE: PUMP AND ALARM ARE TO BE MINIMUM DISCHARGE KATE-- GPM INSTALLED ON SEPARATE .CIRCUITS VERTICAL DIFFERENCE BETWEEN PUMP OFf ANO,OISTRIDUTIOW PIPE.. 32 FEET t MINIMUM NETWORK SUPPLY PRESSURE FLET ♦ L! FEET OF FORCE MAIN X 1'48 FYO PiFRICTION FACTOR.. FEET TOTAL Ot NAMIC. HEAD FEET of 41w1 e E\ tl k INTERNAL DIMEIJSIOIJOF TANK: LEklGTH 419A`TnP ;WIDTH $!"TOP LIQUID DEPTH 9t5''8oT 80?. Zo7ToE'1 /42tsA z31 = GRL- /INCH AS PtrTt M R Ki U FA CI'V Mtly% = Z$ 7 I G Pr I Li c-H TOTAL HEAD IN FEET ~GE V ° r y N N A O) w O N O CC) O Na O O I 1 N O r 1 O ~ O N e o o y e ° • ~ r t'a`i o~ r cn ~ to O O i N (n zJ i o rlo rn o~ W m 0 • N rn O o c 00 N - I - O C) ! O w rn 0 S ° N w Ut O J TOTAL HEAD IN (METERS 'COMMERCIAL TESTING LABORATORY, INC. C E Main Street, P.O. Box 526 01fax, Wisconsin 54730 715-962-3121 800 - 962 - 5227 ST. CROIX ZONING REPORT NO,!, 03909/01 PAGE 1 ST. CROIX COUNTY REPORT DATES 4/13/90 COURTHOUSE DATE RECEIVED! 4/11/90 HUDSON, WI 54016 ATTNS THOMAS C. NELSON zj. Frederick & Katherine Mangine !L OWNER. LOCATIONS 266 Cove Lane, Hudson COLLECTORS M. Jenkins SOURCE OF SAMPLES Kitchen faucet COLIFORMS 0 /100 ml INTERPRETATIONS Bacteriologically SAFE NITRATE-NS 3 ppm Under 10 ppm is safe for human consumption. Con form Bacteria/100 ml Nitrate-Nitrogen, mg/L LAB TECHNICIANS Pam Gane WI Approved Lab No. 19 0 F.\NDEPEN,01 A V > A ( Means "LESS THAN" Detectable Level Approved bye ® PROFESSIONAL LABORATORY SERVICES SINCE 1952 - bu,_ ST. CROIX COUNTY ZONING OFFICE St. Croix County Courthouse Uf 911 4th Street f ~ m^'"Hudson, WI 54016 Telephone - (715)386-4680 The St. Croix County Zoning office offers tshe service F of septic i and water to Lending Institution, inspections private individuals. 1s~at.asi • Please provide the following information, enclose appropriate fee made payable to St. Croix County Zoning office, bandoneail, along with form to the above address. will as soon as possible after fee and form are received. Q -FEE: $ 25.005 HATER TESTING--------------- (For nitrates and coliform bacteria)FEE: $175.00 WATER TESTING (For VOC'S) SEPTIC SYSTEM INSPECTION------- (Determines if system is properly functioning at t me of inspection) i Property owner's name "a-r ihe_P.,ne- /Yjccn at`r~ r~ ~e r~' K rT cr~rv ~ ud o Property owner's address C eve L t~ n o-- Legal Description ,1/4 of the 1/4 of Section a- , T N-R2LO w Town of 1-v Lot Number Subdivision Name f .S'u6 #3) a Realty sign by house?_ Color of house 0 If so, list firm: PLEASE INCLUDE, IF AT ALL POSSIBLE, A MAP,i.e,COPY OF PLAT BOOK, WITH LOCATION SHOWN, AND A COPY OF THE LISTING SHEET. Testing of residential water requires a sample that is fresh. If the home is vacant, and has been so for some time, the water line must be purged by running the water for several hours before the % test can be conducted. WINTER TESTING: Many times water lines are turned off, or sill cocks are turned off, making access to the home necessary. If this is the case, please make proper arrangements with this office to ensure time when entry may be gained. ~ r , 17C ~j /lea ~~#C')r,4-e Firm or individual request in servf ces :Y7 ~et d; Telephone Number - .31 a REPORT TO BE SENT TO: Ou Closing date Signature I 580.3 ? J I I m G ~ ~ ~ O N ~7I QI ~ I 05 u z> ~ ~ / i' d ~°w OS~ I / ~p r CID LIN a O (y~ s W IM ~r ~o~~ .10 r C". 49.L y ~6V y 40 Vol, .0, v 0 °o N d loci ol- r 6y0~ B ` f~ ' O % o F eo w ! d.~ OS ,S 06 51 6 .10 / I 'gyp Q ~b z c 4" N i 1~~1 ~0 9 a c r 105 .9 E l LID a jp .0 10 147,53 147~~ ~i0s, .G. > I b ' aoa , ,rte .L Qll' z4s v Ih 1 0 1 n 6 925 ~ ~ ~ f--- ST. CROIX COUNTY lot WISCONSIN ZONING OFFICE w ' ST. CROIX COUNTY COURTHOUSE .v, 911 FOURTH STREET • HUDSON, WI 54016 - - (715) 386-4680 April 11, 1990 Fredrick Mangine 266 Cove Lane Hudson, WI 54016 Dear Mr. Mangine: An inspection of the septic system of Fredrick & Katherine Mangine located at 266 Cove Lane, Hudson, WI was conducted on April 10, 1990. At the same time I also obtained a water sample and submitted it to the laboratory for testing. The results of that testing will be sent to you as soon as we receive them back from the laboratory. At the time of the inspection, the sanitary system appeared to be functioning properly. The inspection of this sewage disposal system was based upon a surface inspection of said system, and did not involve any excavating or chemical analysis. Accordingly, there is the possibility of hidden defects in the system not discoverable by this inspection. This does not in any way warrant or guarantee the continued proper functioning or operation of this system. It is recommended that the system should be pumped once every three years. Therefore, the prolonged life of this system is totally dependent upon proper maintenance of the system. Should you have any questions regarding this subject, please feel free to contact this office. Sincerely, Mary Jenkins Assistant Zoning Administrator cj